Impact of various treatment modalities on the outcome of stage IB1-IIA cervical adenocarcinoma

Abstract

Objective: To evaluate the outcomes of patients with stage IB1-IIA cervical adenocarcinoma treated by various modalities in order to formulate a better treatment strategy.

Methods: The impact of various treatment modalities on the prognosis of 258 patients with stage IB1-IIA cervical adenocarcinoma was investigated. The therapeutic modalities included radical surgery (n=174); radical surgery followed by adjuvant radiation therapy (RT), such as RT alone or concurrent chemo-radiotherapy (CCRT) (n=46); or primary RT or CCRT (n=38).

Results: As compared with patients in the surgery-only group, patients with 1 postoperative major risk who underwent surgery followed by RT or CCRT had a significantly higher likelihood of disease relapse (2.3-fold, P=0.041) and disease-related death (2.9-fold, P=0.014). The likelihood of recurrence (P=0.32) and death (P=0.58) did not differ between patients who underwent adjuvant RT or CCRT for 1 major risk factor and those who underwent primary RT or CCRT. By contrast, patients with more than 1 major risk factor had a higher likelihood of disease recurrence (2.9-fold, P=0.037) and disease-related death (3.4-fold, P=0.051) than those who underwent primary RT or CCRT.

Conclusion: Radical surgery is recommended for patients with stage IB1-IIA cervical adenocarcinomas without contraindications. Those with more than 1 postoperative pathologic risk factor had the worst prognosis despite adjuvant RT or CCRT.